Frequency and Risk Factors

The incidence of erectile dysfunction is in function of age, so it is very clear (and confirmed by a lot of the studies) that prevalence increases with age, especially after 65 years of age. Interestingly, this prevalence rise is most prevalent in medical staff (doctors). 40 years ago, erectile dysfunction is rare and occurs in only 4% of men and rises to over 50% after 70 years of age.

Risk factors for erectile dysfunction are obesity, elevated blood pressure, physical inactivity, dyslipidemia, chronic stress. Thus, risk factors are completely equal to risk factors for cardiovascular disease. In fact, erectile dysfunction is often a cardiovascular disease, because it is caused by narrowing or blockage of erectile arteries. These arteries are of very small diameter (twice the coronary arteries) and therefore it is important for every male with erectile dysfunction to evaluate his cardiovascular risk, because if we start with appropriate measures, we can prevent a coronary incidence (the incidence of males with erectile dysfunction).

If erection is completely absent or insufficient due to its strength or duration for adequate sexual intercourse, then it is about erectile dysfunction. As we mentioned above, this phenomenon is not so rare; namely, data indicate that half of men over the age of 40 have more or less pronounced erectile dysfunction.

The risk factors for this disorder are similar to those for the development of cardiovascular disease, so that erectile dysfunction is considered to be one of the early signs of atherosclerosis.It is precisely why men with erectile dysfunction have a valid screening of risk factors for cardiovascular diseases such as arterial hypertension, diabetes, hyperlipoproteinemia, obesity and smoking, as well as their adequate treatment or removal.

Namely, some studies have found a link between erectile dysfunction and a greater number of cardiovascular incidents, and premature mortality in males. For example, erectile dysfunction increases the relative risk for any cardiovascular incidence by 44%, 62% of myocardial infarction, stroke by 39%, while the relative risk for death is greater by 25% during six-year follow-up.

From a practical point of view, and given the above data, it can be said that it is very useful in everyday practice to start asking men over 40 years of their sexual life and thus early discover and treat potentially very dangerous health risks . This applies especially to men with some of the risk factors (such as arterial hypertension or diabetes) or smokers.

It is useful to do a screening by completing the IIEF 5 questionnaire (a questionnaire used to establish the International Erectile Function Index), which consists of five issues related to erectile function in the last six months. Each answer is between one and five points. If the sum is 21 or less, then it is advisable to undergo further processing in terms of risk factors, but also hormonal examinations (LH, FHS, total testosterone, free testosterone, estradiol, prolactin, TSH) and eventually doppler artery or electron-neurography. A test that can comprehensively evaluate the erectile function is injecting alprostadil into cavernous bodies to provide an adequate insight into the function and avoid complicated diagnostic processing.